Active NPI
Matthews Florence Kirk, MSW
- Clinical Social Worker
- Jackson, MS
National Provider Identifier
1174731590
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- W0863
- Practice address
- 571 E Beasley Rd
Suite -a
Jackson, MS 39206-3042 - Phone
- (601) 608-4223
- Fax
- (601) 982-5624
- NPI assigned
- May 18, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | W0863 | MS | Primary |
Addresses
Primary practice location
571 E Beasley Rd
Suite -a
Jackson, MS 39206-3042
Mailing address
222 Deerwood Xing
Canton, MS 39046-5353
Phone (601) 608-4223
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| W0863 | MS | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1174731590",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "222 DEERWOOD XING",
"city": "CANTON",
"state": "MS",
"postal_code": "390465353",
"telephone_number": "601-608-4223",
"fax_number": "601-982-5624"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "571 E BEASLEY RD",
"address_2": "SUITE -A",
"city": "JACKSON",
"state": "MS",
"postal_code": "392063042",
"telephone_number": "601-608-4223",
"fax_number": "601-982-5624"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIRK",
"first_name": "MATTHEWS",
"middle_name": "FLORENCE",
"name_prefix": "Miss",
"credential": "MSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MS",
"license": "W0863",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jackson, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.